Provider Demographics
NPI:1841476462
Name:MARKS, JEANNE LOUISE (LICSW)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:LOUISE
Last Name:MARKS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6504 LANDON LN
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-5606
Mailing Address - Country:US
Mailing Address - Phone:301-229-6933
Mailing Address - Fax:301-229-6933
Practice Address - Street 1:6504 LANDON LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-5606
Practice Address - Country:US
Practice Address - Phone:301-229-6933
Practice Address - Fax:301-229-6933
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD036921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD03692OtherBOARD OF SOCIAL WORK EXAM
DCLC301076OtherBOARD OF SOCIAL WORK